Nobuyuki Sekita

Chibaken Saiseikai Narashino Hospital, Tiba, Chiba, Japan

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Publications (26)39.93 Total impact

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    ABSTRACT: Pre-chemotherapeutic factors to assess the prognosis of patients with advanced urothelial carcinoma have not yet been completely established. The immune response of the host to the tumor is lymphocytedependent. However, the effect of lymphocytes on chemotherapy prognosis is unknown. In this study, we investigated the correlation between pre-chemotherapeutic lymphocyte counts and the clinical characteristics of urothelial carcinoma and determined the effectiveness of lymphocytes as a prognostic predictor for metastatic urothelial carcinoma treated with chemotherapy. Between April 2003 and March 2011, data from 34 patients withunresectable or metastatic urothelial carcinoma were retrospectively subjected to multivariate regression analysis to determine the patient characteristics with independent prognostic significance for survival. The median patient age was 71 ; 21 patients were male and 13 female. The number of primary tumors in the pelvis, ureter, and bladder were four, six, and 24, respectively. Seventeen patients underwent prior curative resections, and visceral metastases at chemotherapy were detected in 14 patients. The median lymphocyte count at chemotherapy was 1,292/ml. Cancer-specific survival was significantly lower in patients withlymph ocyte counts <1,000/ml than in patients with lymphocyte counts ≥1,000/μl (p=0. 001). During multivariate analysis, visceral metastasis and lymphocyte counts were independent factors for predicting poor prognosis. In addition, lymphocyte counts of <1, 000/ml or positive visceral metastases also affected survival. This information may be useful for identifying patients who are likely to benefit from chemotherapy.
    Hinyokika kiyo. Acta urologica Japonica 05/2014; 60(5):215-9.
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    ABSTRACT: Tertiary syphilis is recently a rare disease in Japan. In this paper, we report a rare case of syphilitic orchitis. The patient was in his early forties. The left scrotal contents were swelling and a low echoic nodule measuring about 30 mm in diameter was detected on ultrasonography. Serum alpha fetoprotein, lactate dehydrogenase, and beta subunit of human chorionic gonadotropin were within the normal range, whereas Treponema pallidum hemagglutination assay and rapid plasma reagin were strongly positive. High orchiectomy was performed for suspicion of testicular tumor. Histological findings showed the non-specific inflammatory granuloma with lympho-plasmatic infiltration. It was diagnosed as granulomatous inflammation of left testis caused by syphilis.
    Hinyokika kiyo. Acta urologica Japonica 01/2012; 58(1):53-5.
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    ABSTRACT: A 66-year-old woman visited our hospital complaining of painful, irritative urinary symptoms and macroscopic hematuria. Cystoscopy revealed a non-papillary tumor covered with necrotic tissue on the right side of the posterior wall of the bladder. Transurethral resection was performed ; histologically, the tumor was found to be composed of carcinomatous and sarcomatous elements. The carcinomatous element consisted of urothelial and squamous cell carcinomas. The sarcomatous element was composed of osteosarcoma, chondrosarcoma and spindle cell sarcoma. Immunohistochemical examination showed that the carcinomatous component was positive for cytokeratin and the sarcomatous component was positive for S-100 protein. The patient underwent total cystectomy with ileal conduit under the diagnosis of carcinosarcoma. Pathological examination showed no residual tumor. She was followed up with no signs of recurrence or metastasis. Computed tomography (CT) at nine months following surgery showed no evidence of recurrence. However, thirteen months after the operation, she complained of lower abdominal pain, and CT demonstrated a bulky intrapelvic tumor and right hydronephrosis. Her condition worsened rapidly and she died one month later.
    Hinyokika kiyo. Acta urologica Japonica 04/2011; 57(4):199-202.
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    ABSTRACT: No established treatment exists for urachal carcinoma,except curative resection,and its prognosis is poor. More than 80% of urachal carcinomas are adenocarcinomas. We report a case of advanced urachal carcinoma treated with S-1 and cisplatin combination (S-1/CDDP) chemotherapy. The patient,a 61-year-old woman,presented with macroscopic hematuria. A tumor was detected on the bladder dome and transurethral resection was performed. Histopathological findings indicated poorly differentiated adenocarcinoma. Serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels were 3.5 ng/ml and 140 U/ml respectively. Magnetic resonance images indicated an extension of this tumor to the retroperioneal space. Metastasis to her right ischium was suspected from bone scintigraphy results. The tumor was diagnosed as stage IVB (Sheldon's category) urachal carcinoma. After one cycle of S-1/CDDP chemotherapy,the size of the tumor on the bladder dome decreased,after which total cystectomy was performed. The surgical margin of the cystectomy specimen was negative for malignant cells,although poorly differentiated adenocarcinoma was still observed in this specimen. The findings of this study indicate that this therapy might be beneficial for treating advanced urachal carcinomas. This is the second report of successful treatment of advanced urachal carcinoma with S-1/CDDP chemotherapy.
    Hinyokika kiyo. Acta urologica Japonica 08/2010; 56(8):447-51.
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    ABSTRACT: To assess the diagnostic accuracy of serum bone turnover markers for detection of bone metastasis in patients with prostate cancer (PCa) and to assess the usefulness of these markers as predictors of mortality from PCa. Serum total alkaline phosphatase, bone-specific alkaline phosphatase, carboxy-terminal pyridinoline cross-linked telopeptide parts of type-I collagen (1CTP), tartrate-resistant acid phosphatase type 5 b, and prostate-specific antigen (PSA) levels were measured in 222 patients (58 with bone metastasis, 57 with T2M0 PCa, 55 with T3M0 PCa, and 52 without PCa). Multivariate stepwise logistic regression analysis was used to identify independent predictors of bone metastasis. Correlation of serum marker levels with bone metastasis was assessed using receiver operating characteristics analysis. Multivariate Cox proportional hazards analysis was used to predict cause-specific survival in PCa patients with bone metastasis. Serum total alkaline phosphatase, bone-specific alkaline phosphatase, 1CTP, tartrate-resistant acid phosphatase type 5 b, and PSA levels were significantly elevated in patients with bone metastasis, and correlated significantly with the extent of disease on bone scintigraphy. Multivariate stepwise logistic regression analysis demonstrated that serum PSA and 1CTP were significant predictors of bone metastasis. Receiver operating characteristics analyses showed that serum 1CTP level was the most reliable predictor of bone metastasis (area under the curve = 0.85). Multivariate Cox proportional hazards analysis revealed that only serum 1CTP was an independent prognostic factor for PCa-related death. Serum 1CTP level was a more reliable marker than the others to detect bone metastatic spread and to predict survival probability in PCa patients with bone metastasis.
    Urology 03/2010; 75(6):1446-51. · 2.42 Impact Factor
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    Nobuyuki Sekita, Hiroyoshi Suzuki
    International Journal of Urology 06/2009; 16(6). · 1.73 Impact Factor
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    ABSTRACT: The objective of this study was to perform external validation of a previously developed prostate biopsy nomogram (the CHIBA nomogram) and to compare it with previously published nomograms developed in Japanese and overseas populations. Two different cohorts of patients were used: one from the Chiba Cancer Center (n = 392) in which transperineal 16-core biopsy was performed, and another from Chibaken Saiseikai Narashino Hospital (n = 269) in which transrectal 16-core biopsy was carried out. All patients were Japanese men with serum prostate-specific antigen levels less than 10 ng/mL. The predictive accuracy of our CHIBA nomogram and of four other published nomograms (Finne's sextant biopsy-based logistic regression model, Karakiewicz's sextant biopsy-based nomogram, Chun's 10-core biopsy-based nomogram and Kawakami's three-dimensional biopsy-based nomogram) was quantified based on area under the curve derived from receiver operating characteristic curves. Head-to-head comparison of area under the curve values demonstrated that our nomogram was significantly more accurate than all other models except Chun's (P = 0.012 vs Finne's, P = 0.000 vs Karakiewicz's, and P = 0.003 vs Kawakami's). Our nomogram appears to be more useful for the Japanese population than Western models. Moreover, external validation demonstrates that its predictive accuracy does not vary according to biopsy approach. This is the first report to demonstrate that the predictive accuracy of a nomogram is independent from the biopsy method.
    International Journal of Urology 03/2009; 16(4):416-9. · 1.73 Impact Factor
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    ABSTRACT: Our objective was to determine the incidence of inguinal hernia (IH) after surgery for prostatic diseases. Medical records of 395 patients who underwent radical retropubic prostatectomy (RRP; n = 155), open simple prostatectomy (OP; n = 35), or transurethral resection of the prostate (TURP; n = 205) at the Chibaken Saiseikai Narashino Hospital from April 2000 to March 2007 were retrospectively evaluated. The incidence of IH was 23.9% in the RRP group, 18.9% in the OP group, and 2% in the TURP group. Overall, 91.9% in the RRP and 83.3% in the OP group developed an IH within 2 years postoperatively. The laterality of IH after open surgery was mainly on the right side. Subclinical IH were seen in 25% of RRP cases. The existence of subclinical IH was the only significant risk factor for postoperative IH in this analysis. Furthermore, OP and RRP procedures significantly increased the risk of postoperative IH compared with TURP. The hernia-free ratios were significantly lower after RRP and OP than after TURP (vs RRP: P < 0.001; vs OP: P < 0.001). Our findings confirm that a lower abdominal incision itself is associated with postoperative IH in patients undergoing prostate surgery. Attention must be paid to pre-existing subclinical IH through careful preoperative assessment. Patients should be followed for more than 2 years due to the high incidence of postoperative IH.
    International Journal of Urology 01/2009; 16(1):110-3. · 1.73 Impact Factor
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    ABSTRACT: A 69-year-old woman presented with macroscopic hematuria and severe anemia. Cystoscopy revealed flat edematous mucosa with continuous bleeding. Transurethral coagulation and a biopsy of the urinary bladder were performed. Histopathological examination of the biopsy revealed non-Hodgkin's lymphoma of the mucosa-associated lymphoid tissue (MALT) type. Results of a computed tomography scan and gallium scintigraphy suggested that it was a primary malignant lymphoma of the urinary bladder. A urinary tract infection was found and she was treated with antibiotics for 2 weeks. Because of the detection of a Helicobacter pylori (HP) infection in the gastric mucosal biopsy specimens, the patient was subsequently administered HP eradication therapy. Consequently, the lymphoma disappeared and the woman has had no tumor recurrence for the past 25 months.
    Hinyokika kiyo. Acta urologica Japonica 01/2009; 54(12):783-6.
  • International Journal of Urology 01/2009; 181(4):518-519. · 1.73 Impact Factor
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    ABSTRACT: From April 2005 to September 2007, 480 patients underwent transrectal prostate biopsy at our institution. The clinical data including age, serum prostate specific antigen (PSA) level, prostate volume and body mass index (BMI) were obtained, and the cancer detection rates and pathological findings were evaluated in 305 cases with a PSA concentration of 4.0 to 10.0 ng/ml. Prostate volume was calculated from magnetic resonance imaging (MRI) findings. The 305 patients were categorized according to their BMI into three groups (normal, less than 22 kg/m2 ; overweight, 22-25 kg/m2 ; and obese, more than 25 kg/m2). Cancer detection rates and histopathologic findings were compared between the groups. Multivariate logistic regression analysis was also performed. Prostate cancer was detected in 127 patients. No significant differences in BMI were observed between biopsy-positive and biopsy-negative cases (p = 0.965), and the detection rates of prostate cancer observed in the three groups were not significantly different. There was a significant association between BMI and the findings of high Gleason score (more than 4+3) (p = 0.048). BMI was not a contributory factor of prostate cancer detection for cases with intermediate PSA levels; however, patients with high BMI may have high-grade malignancy features.
    Hinyokika kiyo. Acta urologica Japonica 08/2008; 54(7):479-83.
  • Nobuyuki Sekita, Kenichi Egoshi, Kazuo Mikami
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    ABSTRACT: We retrospectively evaluated the possibility of predicting estimated blood loss (EBL) in 39 consecutive patients undergoing retropubic radical prostatectomy (RRP) using pelvimetry under a single surgeon at our institution from April 2004 to March 2006. For pelvimetry, the area of pelvic entrance (APE) and view of prostatic apex (VPA) were evaluated using preoperative images. Other perioperative data were also recorded, including the patient's age, prostate specific antigen (PSA), body mass index (BMI), use of neoadjuvant hormonal therapy, operative time and pathological data (such as pathological T factor and specimen weight). The relationship between these factors and EBL was analyzed. Average EBL was 761 ml (ranging from 232 to 2,149) and autologous blood transfusion was not performed. There was no statistically significant correlation or difference between EBL and perioperative parameters excluding APE, VPA and BMI. Multivariate analysis showed that the most influential factor for EBL was VPA (p = 0.001). A significantly lower EBL was seen in patients with a wide APE (125 or more), good VPA, and acceptable BMI (less than 25 kg/m2) versus other patients (429 +/- 137 ml vs 934 +/- 358 ml, p < 0.0001). Our findings demonstrate the potential of pelvimetric analysis such as the measurement of APE and the evaluation of VPA, as a useful tool for predicting blood loss during RRP. Moreover, these data also indicate that blood preparation may be spared in patients with acceptable BMI, wide APE, and good VPA.
    Hinyokika kiyo. Acta urologica Japonica 01/2007; 53(1):19-23.
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    ABSTRACT: Enterovesical fistula is a very rare complication of primary urological malignancies. A case of ileovesical fistula caused by a bladder carcinoma is presented. A 66-year-old male was referred with complaints of urinary pain. On admission, fecaluria and urinary tract infection with bladder stone were detected. Cystography revealed the passage of contrast medium into the small bowel. Under the diagnosis ofileovesical fistula due to suspected inflammatory disease, sigmoidectomy and segmental small bowel resection with partial cystectomy were performed. Histological evaluation revealed a poorly differentiated urothelial carcinoma. Without further treatment, the patient died from cancer five months after operation. However, it is hard to assess the effect of fistulas on prognosis. Since it has been reported that about 40% of the patients with T4 bladder tumors could be potentially cured with radical resection, we recommend a thorough examination to confirm the diagnosis of primary disease to obtain the best results.
    Hinyokika kiyo. Acta urologica Japonica 11/2006; 52(10):793-6.
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    ABSTRACT: Degradation of collagen, or gelatinolysis, by tumor cells is one of the most important events in tumorigenesis. We investigate the possible relationship between the in situ gelatinolytic activities exerted by matrix metalloproteinases (MMPs) and clinico-pathological factors in renal cell tumor (RCT) patients. Using the film in situ zymography (FIZ) method, we determined in situ localization of MMP-like gelatinolytic activities in cancerous and normal tissues in the kidney (n = 51). To clarify the MMP(s) responsible for the gelatinolytic activity in RCTs, we examined the expressions of MMP-2 and MMP-9 in the kidney tissues by means of gelatin zymography (GZG). MMP expression was also detected by RT-PCR and Western blotting analysis. We then investigated the associations of MMP expression, as detected by GZG, with the intensity of gelatinolytic activity, as determined by FIZ. We analyzed the possible relationship of FIZ findings to several clinico-pathological factors such as tumor size, grade, vessel invasion, histologic type, stage and metastasis. FIZ demonstrated that all tumor and normal kidney tissues showed in situ gelatinase activities, and that gelatinolytic activities in RCTs were much stronger than those of normal kidney tissues. There was a statistically significant correlation between the intensity of MMP-like gelatinolytic activity and tumor size, tumor grade and vessel invasion (p < 0.05), but not between it and histological type, tumor stage or metastatic status. FIZ showed that tumor tissues in 5 of the 6 patients with fatal outcome exhibited the intense gelatinolytic pattern. Stronger in situ gelatinolytic patterns were documented in cases with higher MMP-2 expression. The molecular species of MMPs detected by GZG were confirmed by RT-PCR and Western blotting analysis. The FIZ technique enables a direct assessment of in situ gelatinolytic activity in RCT tissues. The intensity of the activity seems to affect the biology of RCT tissues. Our results also indicate a major role for MMP-2 in in situ gelatinolysis in RCT tissues.
    International Journal of Cancer 10/2003; 106(4):480-5. · 6.20 Impact Factor
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    ABSTRACT: TIAP/m-survivin, a member of the inhibitor of apoptosis (IAP) protein family, is expressed in a cell cycle dependent manner. It is strongly expressed in various subsets of thymocytes. To investigate a role of TIAP/m-survivin in thymocytes, mice carrying the lck-TIAP transgene were established. Two out of six transgenic mice expressed large amounts of TIAP mRNA and protein in thymocytes. Although T cell development and apoptosis of thymocytes were largely unaffected in lck-TIAP mice, transgenic thymocytes displayed hyperproliferation in response to PMA and ionomycin but not to anti-CD3 antibody. Thus, overexpression of TIAP/m-survivin augments cell proliferation of thymocytes to a certain stimulation.
    Molecular Immunology 11/2002; 39(5-6):289-98. · 2.65 Impact Factor
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    ABSTRACT: Thymidine phosphorylase (TP) expression in 100 paired samples of renal cell carcinoma (RCC) and normal adjacent tissue was analyzed by an ELISA method. We also investigated whether TP expression correlates with clinicopathological findings and clinical outcomes of these patients. Median TP expression was 9-fold (range, 0.5-56) higher in primary tumor than in non-cancerous renal tissue (P < 0.0001). There was a significant difference with respect to tumor venous invasion. TP expression was significantly higher in patients with such venous invasion than in those without (P = 0.018). However, there was no correlation between TP level and other clinicopathological findings and the survival curves. These results suggest that ELISA is useful for evaluating TP expression of human RCC and may provide a novel approach to therapy for patients with RCC.
    Japanese journal of cancer research: Gann 03/2002; 93(3):340-5.
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    ABSTRACT: The syndrome of inappropriate secretion of antidiuretic hormone (ADH) was recognized in a 68-year-old man with a poorly differentiated metastatic adenocarcinoma of the prostate. Elevated levels of ADH were found in the tissues of the primary tumor and lymph node metastasis. The patient's clinical course is detailed and the pathophysiology of this syndrome is discussed. To our knowledge, this case is the ninth reported case of syndrome of inappropriate secretion of ADH with adenocarcinoma of the prostate. Antidiuretic hormone activity was proven in only three cases including this case.
    International Journal of Urology 10/2001; 8(9):513-6. · 1.73 Impact Factor
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    ABSTRACT: Expression of the KAI1 gene, a metastasis-suppressor for prostate cancer, is reduced in all foci of prostatic metastasis. The altered regulatory mechanism is not strongly related to mutations or allelic losses of the KAI1 gene in prostate tumors. Since transcriptional silencing of genes has been found to be caused by epigenetic mechanisms, we have investigated the involvement of this epigenetic regulation of KAI1 expression in prostate cancers. The methylation status of the KAI1 promoter region was examined by restriction-enzyme digestion and sequencing, after amplifying a 331-bp fragment in the GC-rich promoter region from 4 human prostate cancer cell lines treated with bisulfite. The same 4 cell lines were also exposed to various concentrations of the demethylating agent, 5-aza-2'-deoxycytidine (5-AzaC) and / or the histone deacetylase inhibitor, trichostatin A (TSA). To clarify the influence of epigenetic modification on reduced KAI1 mRNA expression in the tumor cells, RT-PCR and northern-blot analyses were performed. Bisulfite-sequencing data showed a few methylated CpG islands in the promoter. RT-PCR analysis of 5-AzaC and / or TSA-treated cells indicated reversal of suppression of KAI1 transcription in two cell lines (PC-3 and DU-145), although the expression could not be detected by northern blots. From these results, it is suggested that epigenetic change is not the main mechanism of KAI1 down-regulation, though there remains a possibility that methylation in a more upstream region might be associated with this regulation.
    Japanese journal of cancer research: Gann 10/2001; 92(9):947-51.
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    ABSTRACT: BackgroundCD44 is a metastasis suppressor gene for prostate cancer and the down-regulation of CD44 and its variants is associated with the progression of prostate cancer. Also, hypermethylation of the CpG islands of the CD44 gene is closely associated with transcriptional inactivation, resulting in the decreased expression of CD44. To clarify the exact role of methylation status of CpG islands of CD44 gene in the progression and metastasis of prostate cancer, we investigated the methylation status of this gene in primary and metastatic human prostate tumors obtained from surgery or autopsy.Methods We examined 97 samples from 40 Japanese patients with adenocarcinoma of the prostate. Tumor tissues were obtained from radical prostatectomy specimens from eight patients with stage B, 12 patients with stage C and three patients with stage D1 and at autopsy from 17 hormone-refractory metastatic cases, who had initially responded to the therapy and thereafter relapsed. Distant metastatic tissues were also obtained at autopsy (i.e., liver, lung, kidney, mammary gland, and pelvic lymph nodes) from 10 of 17 hormone-refractory cases. We analyzed the hypermethylation status of CD44 promotor region by PCR using genomic DNAs digested with the m5C-sensitive restriction enzyme HpaII.ResultsThe correlation between the methylation status of CD44 gene and the stage progression of prostate cancer was statistically significant (P = 0.0438). In two of 10 hormone-refractory cases, a comparison of the methylation status of the CD44 gene in metastases to that in primary tumors revealed interfocal heterogeneity of CD44 methylation status.Conclusions These results indicate an important role of CD44 methylation in the progression and metastasis of prostate cancer, although the amount of methylational heterogeneity is substantial among metastatic sites within the same patient. Prostate 49:110–115, 2001. © 2001 Wiley-Liss, Inc.
    The Prostate 09/2001; 49(2):110 - 115. · 3.84 Impact Factor
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    ABSTRACT: Expression of the KAI1 gene, a metastasis-suppressor for prostate cancer, is reduced in all foci of prostatic metastasis. The altered regulatory mechanism is not strongly related to mutations or allelic losses of the KAI1 gene in prostate tumors. Since transcriptional silencing of genes has been found to be caused by epigenetic mechanisms, we have investigated the involvement of this epigenetic regulation of KAI1 expression in prostate cancers. The methylation status of the KAI1 promoter region was examined by restriction-enzyme digestion and sequencing, after amplifying a 331-bp fragment in the GC-rich promoter region from 4 human prostate cancer cell lines treated with bisulfite. The same 4 cell lines were also exposed to various concentrations of the demethylating agent, 5-aza-2-deoxycytidine (5-AzaC) and/or the histone deacetylase inhibitor, trichostatin A (TSA). To clarify the influence of epigenetic modification on reduced KAI1 mRNA expression in the tumor cells, RT-PCR and northern-blot analyses were performed. Bisulfite-sequencing data showed a few methylated CpG islands in the promoter. RT-PCR analysis of 5-AzaC and/or TSA-treated cells indicated reversal of suppression of KAI1 transcription in two cell lines (PC-3 and DU-145), although the expression could not be detected by northern blots. From these results, it is suggested that epigenetic change is not the main mechanism of KAI1 down-regulation, though there remains a possibility that methylation in a more upstream region might be associated with this regulation.
    Cancer Science 08/2001; 92(9):947 - 951. · 3.48 Impact Factor

Publication Stats

276 Citations
39.93 Total Impact Points

Institutions

  • 2008–2014
    • Chibaken Saiseikai Narashino Hospital
      Tiba, Chiba, Japan
  • 1999–2010
    • Chiba University
      • • Department of Urology
      • • Department of Neurology
      Chiba-shi, Chiba-ken, Japan
  • 2002
    • Kyushu University
      Hukuoka, Fukuoka, Japan
  • 2001
    • Chiba University Hospital
      Tiba, Chiba, Japan